Foundation for the integration of biologically based therapy in the management of prostate cancer

The cure of advanced prostate cancer (PCa) will be achieved through the clinical application of biological observations. To achieve this, a new classification of human PCa is needed. Unlike in previous classifications of PCa which were based on anatomic determinates of outcome, we propose to integrate emerging PCa biology into this taxonomy. Three biologically based categories were identified (amphotropic, clonal expansion, and heterotopic), and each has unique features that influence therapy selection. It is unlikely that any single agent or modality will successfully control PCa. It is hoped that the classification and trial designs we propose will facilitate the application of integrated treatment and prevention strategies.